Caregiving model: living with an elderly parent in your home

To ending
From Onset

The Caring Generation, with host Pamela D. Wilson: Living With Elderly Parents Radio Show

https://pameladwilson.com/living-with-elderly-parents-the-caring-generation/

This is a great program for anyone thinking about having an elderly parent move into their home. Pamela Wilson provides information to discuss and consider prior to making a commitment of this magnitude. 

In-home caregiving is the model my husband and I undertook to provide care for his mother. Our arrangement had one major difference:  I assumed the role of primary caregiver as a daughter-in-law.  Our experience is detailed in What to Do about Mama?  

Although our caregiving situation had a number of positives, there was also more difficulties than we ever foresaw. I am highlighting those points because they have the most significant application to the disintegration of our caregiving arrangement.

  • Although we discussed the arrangement extensively with all family members beforehand, we did not establish firm parameters of shared responsibility in a formal, written, and a notarized agreement.
  • We made sacrifices above and beyond what the others were willing to do, which eventually led to resentment.
  • We did not realize how much sharing our home would change our spousal relationship.
  • Unanticipated details surrounding the situation can create unforeseen complications.
  • We underestimated escalating needs, which increased the scope of responsibilities.  Neither did we fully anticipate the number of years involved with providing care.
  • We did not recognize the differences in our family cultures, which led to serious misunderstandings. 
  • Over time, caregiving can become a trap that can undermine the adult child-parent relationship, as well as relationships with other family members.
  • Caregiving can be very long-term. We did not prepare a contingency plan for if and when the arrangement became unmanageable. 
Remember:  Do not enter a live-in caregiving arrangement lightly. 


An interview with the authors of “What to Do about Mama?: A Guide to Caring for Aging Family Members”

An interview with the authors of "What to Do about Mama?: A Guide to Caring for Aging Family Members".


Shared Responsibility

An AgingCare.com article “Getting Your Siblings to Help with Caregiving” by Linda Hepler, BSN, RN, stresses the importance of sharing caregiving responsibilities with siblings and makes suggestions about how to accomplish a cooperative family relationship.

See: http://www.agingcare.com
Home » Caregiver Support » Family & Relationships » Articles » Getting Your Siblings to Help With Caregiving

Hepler states that when an elderly parent’s health begins to fail, one adult child generally becomes the primary caregiver. And while this may work well for a time, it can eventually cause resentment when you find yourself shouldering most of the burden—especially if other siblings live nearby yet don’t help out. She then goes on to make the following recommendations:

  • Call a family meeting
  • Make a written agenda
  • Do as much listening as talking
  • Be specific about what you want
  • Divide up tasks
  • Don’t expect total equality

Hepler stresses that it’s normal to experience tricky dynamics when siblings get together as adults, since childhood jealousies and rivalries as well as historical grudges may resurface under the pressure to work together and make sacrifices.

Hepler recommends that if all else fails, an option for getting past stressful communication is a relatively new concept—family mediation—an informal process in which a neutral third party sits down to help people in conflict to better understand their individual interests and needs so that they can agree upon a workable solution to the problem.

Hepler emphasizes that even when successful in achieving a better distribution of responsibility, it’s important to communicate, communicate, communicate.

We have discussed the family meeting previously (See the February 22, 2014 entry: “Family Meeting”), but the concept of “shared responsibility” with siblings cannot be overstressed. It is a major concept in my book, “What to Do about Mama?” and is central to chapter 2, in which I recount my own personal caregiving story, including experiences with family meetings and family mediation. Following are some excerpts from the book, relevant to this topic:

  • A productive family meeting can build a strong foundation for family caregiving. Do you share common values? Talk about what is most important to all of you—autonomy or safety. Establish common goals. Divide responsibility based on the strengths and abilities you bring to the family. It is important to be specific. Develop a contract that delineates the commitments family members have made, and solidify those commitments with signatures that verify that everyone understands and agrees to the plan. Be sure to date the contract in case changes are needed later on. WTDAM p.54
  • You’ve taken on the responsibility of family caregiving. You may have held a family meeting to set up a care plan. In an ideal world, all the family members would have done their best to foster a nurturing caregiving relationship among everyone involved—parent(s) and children alike. You have embraced mutual trust, respect, kindness, and patience. You have rejected guilt and resentment. You communicate effectively, based on listening to what everyone is saying. You compromise when problem-solving to find the solution that works best for everyone. You and the family have assigned tasks according to individual strengths and skills and with an awareness of individual needs. You share caregiving responsibilities, and have found that teamwork reduces tension and brings your family closer together. It even promotes the possibility of healing old wounds. You keep your expectations realistic, and your family members, in turn, provide you with needed emotional support. They allow you to vent and take steps to alleviate your stress.

    How well does this describe your family’s caregiving experience? In the real world, when there’s a pressing need to collaborate and make important decisions (especially with a resistant parent), you may not all be in top form, but, rather, anxious and overwhelmed. Your relationships may be knocked off balance by the magnitude of caring for aging or failing parents. Feelings for each other shift, sometimes weakening the ties and intensifying sibling rivalries of the past. There may be jealousies related to perceived “favored children” or worries about issues of inheritance. A frequently reported caregiver frustration is the lack of consistent help from other family members; a large portion of sibling caregivers (40%) end up having serious conflicts with each other. Most of us do not even see that we are about to become mired in the quicksand until we step in it and it begins to suck us down. WTDAM pp. 107-108